| Family Care Associates | |
|
702 Russell Ave Ste 100 Gaithersburg MD 20877-2605 | |
| (301) 330-0006 | |
| (301) 330-0444 |
| Full Name | Family Care Associates |
|---|---|
| Speciality | Clinic/Center |
| Location | 702 Russell Ave Ste 100, Gaithersburg, Maryland |
| Authorized Official Name and Position | Gennady Vinokur (MANAGER) |
| Authorized Official Contact | 3013300006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Care Associates 702 Russell Ave Ste 100 Gaithersburg MD 20877-2605 Ph: (301) 330-0006 | Family Care Associates 702 Russell Ave Ste 100 Gaithersburg MD 20877-2605 Ph: (301) 330-0006 |
| NPI Number | 1003151291 |
|---|---|
| Provider Enumeration Date | 11/29/2012 |
| Last Update Date | 07/02/2020 |
| Certification Date | 07/02/2020 |
| Medicare PECOS PAC ID | 8325283229 |
|---|---|
| Medicare Enrollment ID | O20130326000017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003151291 | NPI | - | NPPES |
| Provider Name | Anitha Kandaswamy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528383445 PECOS PAC ID: 1850514191 Enrollment ID: I20140514000773 |
| Provider Name | Memouna M Foudjou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578967972 PECOS PAC ID: 1658695440 Enrollment ID: I20150128000400 |
| Provider Name | Francis Ihejirika |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124797287 PECOS PAC ID: 6901297233 Enrollment ID: I20211222000069 |
| Provider Name | Eboni Clipper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083063887 PECOS PAC ID: 0143694299 Enrollment ID: I20240229003944 |
| Provider Name | Tracy Tsao |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528620424 PECOS PAC ID: 2668812835 Enrollment ID: I20240506000031 |
| Provider Name | Loretta Lukic |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134427131 PECOS PAC ID: 1355886110 Enrollment ID: I20241014003953 |
| Provider Name | Trac Nguyen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033842976 PECOS PAC ID: 7618412305 Enrollment ID: I20241018001245 |
| Provider Name | Irene Mah Mebune |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003684192 PECOS PAC ID: 3577090760 Enrollment ID: I20241230002624 |
| Provider Name | Pilar Thompkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720265986 PECOS PAC ID: 2264976547 Enrollment ID: I20250106000526 |
| Provider Name | Rachidetou Njoya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215655923 PECOS PAC ID: 1456897941 Enrollment ID: I20250108000122 |
| Provider Name | Ruth Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962053900 PECOS PAC ID: 2567998370 Enrollment ID: I20250114000400 |
| Provider Name | Autumn Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407674120 PECOS PAC ID: 9931638798 Enrollment ID: I20250123000470 |
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